Dermatome with threaded and adjustable guide rod for cutting skin grafts of varying thickness



Aug. 26, 1'. R. VERMILLION 2,426,381

' v DERMATOME WITH THREADED AND ADJUSTABLE GUIDE ROD -FR CUTTING SKIN GRAFTS.0F VARYING' THICKNESS Filed June 11, 1946 INVENTOR. jkozrwlilermillziow,

Amfi

v QN

mm. 2 N

g? m H w @H M 7 N on V NN 3 an a .n 9N NN @N mN v bu @N a r i L H L E r v Patented Aug. 26, 1947 DERMATOME WITH THREADED AND AD- JUSTABLE GUIDE ROD FOR CUTTING SKIN GRAFTS OF VARYING THICKNESS Thomas R. Vermillion, Williamsburg, Va.

Application June 11, 1946, Serial No. 676,005

14 Claims. 1

This invention relates to a surgical instrument and, more particularly, to that class of surgical instruments known as dermatomes.

One of the principal objects of this invention is to provide a dermatome wherein the surgeon may easily manipulate the same to cut skin grafts of varying sizes and thicknesses. More specifically, it is an object of this invention to provide a dermatome wherein the surgeon may cut a skin graft which may be thicker at one portion thereof than the other.

Another important object of the invention is to provide a dermatome wherein a portion thereof functions to transfer the blood, or a portion thereof, from the incision, as the incision progresses, to the upper side of the skin graft as the graft is being formed, thus enablin the surgeon to have a better view of the incision, and thereby permitting the surgeon to cut the graft more rapidly.

Another important object is to provide a dermatome of simple construction wherein a portion of the structure which enables the surgeon to cut skin grafts of varying thicknesses also functions to transfer the blood formed by the incision to the skin graft.

Another object of the invention is to provide a dermatome wherein a portion of the structure thereof which enables a skin graft to b formed of varying thicknesses functions still further to protect the cutting edge of the blade from damage when the dermatome is not being used.

Other objects of the invention are to provide a dermatome which is formed of relatively few parts; which may be easily taken apart for cleansing and sterilizing and thereafter easily assembled; wherein the cutting blade may be easily removed for sharpening or replacement; wherein a standard size surgical blade may be utilized; and which may be cheaply made.

In general terms, the dermatome comprises a handle and an elongated base, the handle being preferably, though not necessarily, formed integrally with the base. The elongated base has an elongated slot formed in one edge thereof so that a standard surgical blade may be longitudinally inserted into the slot. A thumb screw is inserted into the end of the base and is adapted to contact the base end of the blade to firmly secure the blade to the base. A guide rod is mounted on the base and is positioned above the cutting edge of the blade. An important feature of the invention is the manner of mounting the guide rod. Two upstanding, laterally-spaced lugs having apertures therethrough are positioned on the base, preferably just beyond either end of the blade. A pair of arcuately shaped arms ar pivotally mounted to said upstanding lugs. The outer free ends of the arcuate arms carry the guide rod, the guide rod being mounted through suitable apertures in the free ends of the arms so that the guide rod is free to rotate and also free to slide longitudinally relative to the arcuate arms and hence relative to the cutting blade. Adjusting screws extend through each of the arcuate arms and are anchored to laterallyspaced slotted lugs, the latter being mounted on and extending outwardly from the base. Rotation of the adjusting screws will raise or lower the arcuate arms, thus raising and lowering the guide rod relative to the base in a substantially vertical plane, and hence relative to the cutting edge of the blade. As each adjusting screw may be operated independently of the other, the guide rod may be vertically adjusted relative to the cutting edge of the blade so that the guide rod may extend parallel to the cutting edge of the blade at any suitable distance therefrom or the guide rod may assume any desired angular relation to th cutting edge of the blade. Thus, a skin graft may be formed which has the desired uniform thickness throughout its width, or the graft may be thinner at one side thereof than the other. The guide rod is provided with a plurality of grooves formed in the periphery thereof throughout the major portion of its length. As the guide rod is mounted for free longitudinal and rotary movement, and particularly as the guide rod is mounted above the cutting edge of the blade so that a portion of the guide rod extends beyond the blade, the blood formed by the incision is picked up in the grooves. As the graft which is being formed is in contact with the guide rod, a large portion of the blood will be transferred from the incision as it progresses to the upper surface of th skin graft as it is being formed.

It will be noted that the adjustment screws may be actuated to position the guide rod parallel to and in contact with the cutting edge of the blade so that the cutting edge will be protected from damage when th dermatome is not in use.

Referring now to the drawings- Figure 1 is a top plan view of the dermatome, showing all of the parts in assembled position;

Figure 2: is a bottom plan View, partly in section, of the dermatome;

Figure 3 is a side view of the dermatome;

Figure 4 is an end view of the dermatome; and

Figure 5 is an enlarged fragmentary view of one end of the base of the dermatome.

As seen in the drawings, reference numeral I indicates the handle which is formed of heavy solid steel and continues outwardly to a base ll preferably, though not necessarily, formed integrally with the handle. The weight of the handle and base, together with the parts associated with the base, are so apportioned as to provide a dermatome ideally balanced for its intended function.

The base has an elongated groove I2 extending from its outer end inwardly for substantially the entire length thereof. A standard surgical cutting blade I3 is adapted to slide longitudinally through the groove I2, so as to assume the position shown in Figures 1 and 2. The outer end of the groove I2 is provided with screw threads I4 and a thumb set screw I5 is adapted to cooperate with the screw threads I4 and contact the outer base end of the blade I3 to securely lock the blade I3 to the base II.

A pair of laterally-spaced lugs I6 having screw threaded apertures I'I therein are mounted on the base I I so as to extend upwardly therefrom. These lugs I6 are preferably, though not necessarily, formed integrally with the base I I. A pair of arcuately-shaped arms 20, having apertures at either end thereof, are pivotally mounted to the upstanding lugs I6 by means of suitable pivot screws 2|. As the pivot screws 2| are secured to the upstanding lugs I6, the inner portions of the arcuate arms are free to pivot on the screws 2| about the upstanding lugs I6.

The outer free ends of the arcuate arms 23 have apertures therethrough for the insertion of a guide rod 25. The diameter of the apertures in the outer free ends of the arcuate arms 20 and the diameter of the guide rod. 25 are such that the guide rod 25 may rotate freely and slide longitudinally relative to the arcuate arms 2! It will be noted that the guide rod 25 has an enlarged shoulder at each end thereof, one of said shoulders being screw-threaded onto the guide rod; thus one of the shoulders 26 ma be removed from the guide rod 25 when it is desired to remove the guide rod from the arcuate arms.

The guide rod 25 has a plurality of spirallyshaped grooves 21 formed in the major portion of the length of the guide rod for purposes to be hereinafter described.

A pair of lugs 30 are preferably, though not necessarily, formed integrally with the base I! and extend outwardly therefrom in a substantially horizontal plane and positioned above the horizontal plane of the blade I3. These lugs 39 are provided with slots 3|. A pair of adjusting screws 33 extends through screw-threaded apertures formed in the arcuate arms 20. The lower portion of the adjusting screws 33 is provided with a reduced portion 34 and a head 35, the reduced portion 34 being adapted 'to enter the slots 3| formed in the lugs 30, and the head functioning to anchor the adjusting screws 33 to the lugs 30.

Assuming that the dermatome is broken down into all of its component parts, and it is desired to assemble the same after it has been thoroughly cleansed and sterilized, the blade I3 is slid longitudinally through the elongated slot I2 formed in the base I I. After the blade has been shoved inwardly as far as it will go, the set screw I5 is then positioned in the screw threads I4 and tightened therein. As the forward end of the set screw I5 abuts the base end of the blade I3, the

blade is held securely to the base I I. Thereafter, the adjusting screws 33 are threaded through the apertures in the arcuate arms 20, and the pivot screws H are inserted through the apertures formed on the inner ends of the arms 20. The arm assemblies are then positioned so that the reduced portion 34 of the adjusting screws 33 enter the slots 3| formed in the lugs 30 and the pivot screws are then screwed into the screwthreaded apertures I7, formed in'the upstanding lugs I ii. One of the shoulders 26 is removed from the guide rod 25 and the guide rod is then inserted through the outer apertures formed in the arcuate arms 28 and the removed shoulder is then replaced on the guide rod. The dermatome is then completely assembled, as illustrated in the drawings.

If the dermatome is not to be used immediately after assembly, the adjusting screws 33 are rotated to lower the guide rod 25 into contact with the cutting edge of the blade I3. As is indicated in Figs. 2 and 4, the guide rod extends outwardly beyond the cutting edge and thus protects the cutting edge from damage. After the surgeon has determined the size, shape and thickness of the skin graft to be formed, the adjustin screws 33 are then independently actuated so as to vertically position the guide rod 25 above the cutting edge of the blade I3. As has been indicated hereinbefore, the guide rod 25 may be adjusted so as to extend any suitable distance above the blade I3 in parallel relationship therewith, or the guide rod 25 may extend at any desired angle to the blade I3 so that the graft may be thinner at one side than at the other. The purpose of forming irregularlyshaped grafts is, of course, well known to surgeons skilled in the art of grafting skin to injured persons.

Assuming, now, that the guide rod has been suitably adjusted relatively to the blade I3 to form the particular size and shape of graft de-.

sired, the surgeon then makes the incision on the donor in the usual manner. As the cuttin continues, the graft formed extends between the guide rod 25 and the blade I 3 and base II. The blood formed by the incision collects in the spiral grooves 21 formed in the periphery of the guide 25 and as the guide rod 25 is mounted for free rotation, the friction between the upper portion of the skin graft as it is being formed on the guide rod will rotate the guide rod. Thus, the blood is transferred from the incision to the upper portion of the graft as the incision progresses and as the graft is being formed.

I claim:

1. A dermatome comprising a base, a blade having a cutting edge mounted on said base, means on said base for preventing movement of said blade when said dermatome is in use, a guide rod, means for mounting said guide rod on said base and positioned above said blade for free rotary movement, and means for vertically adjusting said guide rod relative to said base and said blade.

2. A dermatome comprising a base, a blade having a cutting edge mounted on said base, a guide rod, means for mounting said guide rod on said base and positioned above said blade, and independent means for vertically adjusting each end of the guide rod relative to the blade so that the rod may extend parallel to the blade and at various angles thereto, depending upon the actuation of each of said adjusting means.

3. A dermatome comprising a base, a blade having a cutting edge mounted on said base, a

guide rod, means for mounting said guide rod on said base and positioned above said blade for free rotary movement and longitudinal movement relative to said blade, and independent means for vertically adjusting each end of the guide rod relative to said blade so that the rod may extend parallel to the blade and at various angles thereto, depending upon the actuation of each of said adjusting means.

4. A dermatome comprising a base, a blade removably mounted on said base, said blade having a cutting edge, means for rigidly securing said removable blade to said base, a guide rod, said guide rod having screw threads thereon for transferring blood resulting from the incision from the incision to the graft as it is being cut, and means for mounting said guide rod on said base and positioned above said blade for free rotary movement and longitudinal movement relative to said blade.

5. A dermatome comprising a base, a blade removably mounted on said base, said blade havin a cuttin edge, means for rigidly securing said removable blade to said base, a guide rod, said guide rod having screw threads thereon for transferring blood resulting from the incision from the incision to the graft as it is being cut, means for mounting said guide rod on said base and positioned above said blade for free rotary movement and longitudinal movement relative to said blade, and means for vertically adjusting said guide rod relative to said blade.

6. A dermatome comprising a base, a blade removably mounted on said base, said blade having a cutting edge, means for rigidly securing said removable blade to said base, a guide rod, said guide rod having screw threads thereon for transferring blood resulting from the incision from the incision to the graft as it is being cut,

-means for mounting said guide rod on said base and positioned above said blade for free rotary movement and longitudinal movement relative to said blade, and means for independently adjusting either end of said guide rod relative to said blade.

7. A dermatome comprising an elongated base,

I a handle secured to said base, an elongated slot from the incision from the incision to the graft, v

and means for mounting said guide rod on said base and positioned above said blade for free rotary and longitudinal movement relative to said blade.

8. A dermatome comprising a base, a blade having a cutting edge secured to said base, a guide rod, means for mounting said guide rod on said base and positioned above said blade, said mounting means including a pair of laterally spaced arms pivotally connected to said base, and separate independent means for raising and lowering said arms to effect an independent vertical adjustment of either end of said guide rod relative to said blade,

9. .A dermatome comprising a base, a blade having a cutting edge secured to said base, a guide rod, means for mounting said guide rod on said base and positioned above LEtld blade for free rotary movement, said mounting means including a pair of arms having one end pivotally connected to the base, an aperture in the free end of said arms, said guide rod being mounted on said arms through said apertures, andmeans for raising and lowering said arms for vertically adjusting said arms relative to said base.

10. A dermatome comprising a base, a blade having a cutting edge secured to said base, a guide rod, means for mounting said guide rod on said base and positioned above said blade for free rotary movement, said mounting mean including a pair of arms having one end pivotally connected to the base, an aperture in the free end of said arms, said guide rod being mounted on said arms through said apertures, and means for raising and lowering said arms for vertically adjusting said arms relative to said base, said adjusting means including a pair of laterally spaced slotted lugs mounted on and extending outwardly from said base and a pair of screw threaded adjusting bolts extending through said arms, the lower portion of said adjusting bolts being removably anchored through the slots in said lugs.

11. A dermatome comprising a base, a cutting blade secured to said base, a guide rod, means for mounting said guide rod on said base and positioned above said blade, said mounting means including a pair of arcuately shaped arms pivotally connected at laterally spaced points on said base, said guide rod being mounted on the free end of said arms, and adjusting screws for raising and lowering said arms to thereby vertically adjust said guide rod relative to said base.

12. A dermatome comprising a base, a cutting blade secured to said base, a guide rod, means for mounting said guide rod on said base and positioned above said blade, said mounting means including a pair of laterally spaced lugs mounted on and upstanding from said base, a pair of arcuately shaped arms pivotally mounted on said lugs, the outer free ends of said arms having apertures therein, said rod being slidably mounted through said apertures in said arms, and means for raising and lowering said arms for vertically adjusting said rod relative to said blade, said adjusting means including a pair of laterally spaced slotted lugs mounted on and extending outwardly from said base, and a pair of screw threaded adjusting bolts extending through said arms, the lower portion of said adjusting bolts being removably anchored through the slots in said lugs.

13. A dermatome comprising an elongated base, a handle secured to said base, an elongated slot formed in one edge of said base, an elongated blade mounted in said slot having a cutting edge extending beyond said base, said blade being adapted to slide longitudinally in said slot for insertion and removal of said blade relative to said base, means for rigidly securing said blade to said base, a guide rod, a portion of said guide rod having grooves formed in the periphery thereof for transferring blood resulting from the incision of said blade from the incision to the upper portion of the graft as the graft is being formed, means for mounting said guide rod on said base and positioned above said blade for free rotary movement and longitudinal movement relative to said blade, said mounting means including a pair of arms pivotally connected at laterally spaced points on said base, the free outer ends of said arm having apertures therethrough, said rod being slidably mounted through said apertures in said arms, and means for independently raising and lowering each of said arms to effect a vertical adjustment of said rod relative to said blade.

14. A dermatome comprising an elongated base, a handle secured to said base, an elongated slot formed in one edge of said base, an elongated blade mounted in said slot having a cutting edge extending beyond said base, said blade being adapted to slide longitudinally in said slot for insertion and removal of said blade relative to said base, means for rigidly securing said blade to said base, a guide rod, a portion of said guide rod having grooves formed in the periphery thereof for transferrin blood resulting from the incision of said blade from the incision to the upper portion of the graft as the graft is being formed, means for mounting said guide rod on said base and positioned above said blade for free rotary movement and longitudinal movement relative to said blade, said mounting means including a pair of laterally spaced lugs mounted on and upstanding from said base, said lugs having apertures therein, a pair of arcuately shaped arms having an aperture adjacent the inner and outer ends thereof, a pair of pivot bolts extending through the respective inner apertures in said arms and through said lug apertures for pivotally mounting said arms to said base, said rod being slidably mounted through the outer apertures in REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Number Name Date 2,400,336 Bishop May 14, 1946 1,516,071 Apolant Nov. 18, 1924 1,736,246 Blair Nov. 19, 1929 1,594,613 Hagen Aug. 3, 1926 2,236,067

Poth Mar, 25, 1941 OTHER REFERENCES Journal of the American Medical Association, Oct. 26, 1946, page 449.

Journal of Experimental Medicine, May 1, 1946, page 338, Activation of Skin Grafts. 

